| NPI | 1205904521 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 25089) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 12677131) |
| 1041C0700X Social Worker, Clinical (Licence: WI 6986123) | |
| 1041C0700X Social Worker, Clinical (Licence: TN 5075) | |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2022-07-21 |